I would never dream of making a diagnosis of any kind, or encouraging you to self-diagnose, especially based on “symptoms of life”, and that’s one reason why I’ll never write a best-selling fad diet book. Pity really, I could do with the cash, my payments from Big Pharma seem to be lost in the post. I admit it: I am ticked off by Wheat Belly, mainly because I am conflicted. Wheat Belly is by now pretty comprehensively debunked, but the frustrating thing about being a skeptic is that not only will a lie travel round the world why the truth is still getting its boots past peer-review, but the zombie corpse of the lie will rise up for at least 15 sequels and probably a video game franchise as well. I am a card-carrying, medically diagnosed coeliac. I was diagnosed in 2012 following a tissue transglutaminase antibody (TTGA) blood test, and then a nice doctor stuffed a tube down my throat and took a duodenal biopsy, which showed classic villous atrophy. And I changed my diet and now I don’t feel sick, don’t have anaemia, and my osteoporosis is probably on the mend, too. It’s all going swimmingly, in fact. And to be honest, without knowing about coeliac none of my health history makes a lot of sense. I can see the signs right back to my childhood. The only downside is, I have to eat gluten free (GF). I don’t know whether to laugh or cry, really. The fad diet has massively increased the prominence and availability of gluten free, but it’s happened in a way that’s quite likely to lead to a backlash and there’s no guarantee that the products will remain available after the fad dies down. I can be reasonably confident that the number of coeliacs has not increased by 15% in a year, which is the increase in the size of the GF market according to Neilsen. Not only is gluten one of the 14 allergens that must now be identified on food labels, but lots of restaurants now have gluten free menu options. My local pub specializes in GF and even has GF ale. The only thing is, this demand for gluten free has, as you’ll have guessed by now, been from two sources: the coeliac community (who tend to be terribly nice, patient people who spend ages talking to chefs about cross-contamination), and – well – non-coeliac self-declared gluten sensitives. And the problem with the latter is that they are almost certainly not gluten sensitive, which means that cross-contamination is not an issue for them and they will often scoff wheat-based products on the side. This annoys the hell out of those places which do gluten free properly. It is hard work, and to have some idiot demand gluten free and then eat a big chunk of cake is really quite aggravating, I’m told. Although gluten is flagged as an allergen, coeliac is not an allergy, it’s an autoimmune disorder. If I eat gluten I will not suffer anaphylaxis and die, but I will not enjoy the next 48 hours (I usually round this off with a migraine, which is not uncommon).Wheat allergy is different, and potentially serious, but significantly less common than coeliac. Non-coeliac gluten intolerance is controversial. It may be a thing, or it may not, I think it’s too soon to tell. Gluten has been on and off the agenda for quacks and charlatans, but moved firmly into the limelight with the publication of William Davis’ Wheat Belly in 2011. As with many fad diet books, it became a runaway best-seller and scored him an interview on Dr. Oz. And we all know how to spot promotion of a bogus miracle diet on Dr. Oz: Oz’s mouth moves . Ironically, having promoted Wheat Belly, Oz now says GF is a scam. It’s like trying to keep track of whether something causes or cures cancer in the Daily Mail. If you think you may be suffering from a reaction to gluten, but you haven’t been diagnosed coeliac, then you may very well be right: although coeliac is reckoned to be inherited and inherent, very large numbers of previously undiagnosed adults are now being detected. The average age of adult diagnosis is around 45, and it’s currently most frequently diagnosed between 40 and 60. So, if you think you have a problem with gluten, go and see your doctor – but don’t change your diet until you have a diagnosis, because the symptoms will disappear if you’re eating GF and you may be required to switch to a high gluten provocation diet in order to be tested properly. Do remember that coeliac is diagnosed by physicians using well-documented diagnostic tests, usually not by dietitians and certainly not by “nutritionists,” naturopaths, chiropractors or any of the rest of the legion of people playing doctor with real patients. A GF lifestyle is more expensive and, contrary to the usual claims made by cranks, may well lead to weight gain, not loss, as many of the common replacements for gluten contain more fat and more calories. Gluten free bread is effectively cake, and is either preserved to within an inch of its life or goes stale in about fifteen minutes - I wonder if Vani Hari came up with the idea of yoga mat subs after eating gluten free ones. And finally: a bit of irony that I absolutely love. There is a vaccine in the works which, if it turns out to be effective, would allow coeliacs to eat wheat. Knowing how rabidly anti-vaccine the alt-med counterculture is, I would be willing to bet that if this happens, the largest community of people eating gluten-free will be those who don’t need to. And then I will point and laugh.

Guy Chapman is a British skeptical blogger, nerd, amateur baritone and Wikipedia administrator. According to homeopaths he is a pharma shill, a teenager with an IQ of under 80 and lives with his mother. Bless them. You can follow him @Sceptiguy - and do check out his Quackford English Ducktionary.

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